鼻咽癌调强放疗中对位听神经束保护的临床研究

来源 :第七届全国鼻咽癌学术大会 | 被引量 : 0次 | 上传用户:utpaxiao
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  [目的]通过研究在鼻咽癌患者的调强放疗中,引入患者MRI图像的扩散张量成像DTI序列,进行位听神经纤维束走向的追踪,并在调强计划中限制其受照剂量,以达到降低患者听觉功能损伤发生风险的目的。[方法]共选取17例各分期的鼻咽癌患者,扫描获得MRI的T1WI、T2WI和DTI序列图像分别与定位CT图像融合。使用BrainLAB公司的iPlan放疗计划系统中的Fiber Tracking功能模块针对患者DTI序列图像数据进行位听神经纤维束的追踪,并将结果传输至调强放疗计划系统Pinnacle3上,在调强计划优化时,进行剂量限制优化,最终降低位听神经区域的平均剂量。[结果]位听神经束追踪结果与实际解剖结构较一致。在调强计划优化中,在不影响靶区剂量的同时,位听神经纤维束的平均剂量数值明显降低。[结论]在鼻咽癌的调强放疗计划设计时,引入MRI的各序列图像与CT图像融合,针对应用DTI图像追踪获得的位听神经纤维束进行剂量保护,可有效减少位听神经区域的受照剂量,降低患者的放射听力损伤,改善鼻咽癌患者放疗后的生活质量。
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